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169
Mayday Hospital 15
Elsewhere 33
Cases found normal, 35 Cases found abnormal, 97
Of the abnormal cases 53 were treated at the Clinic or at home
and 44 were admitted to Mayday Hospital for treatment.
Puerperal Sepsis and Puerperal Pyrexia Admitted to the Borough
Hospital.
During the year there was a very great increase in the number
of Puerperal Infections admitted to the Borough Isolation Hospital
at Waddon. There were twenty-seven admissions. Eighteen were
examples of true puerperal fever, while nine were cases of puerperal
pyrexia. There were eight deaths from puerperal fever in the
Borough Hospital and one in Mayday Hospital.
It is difficult completely to explain this sharp rise in the
frequency of the condition, but two points require mention.
Firstly, eleven of the cases came from only three individuals. One
midwife had five cases, a second had four, and a practitioner had
two. Among these eleven cases there were no fewer than seven
of the deaths recorded. The most rigid investigation was conducted
but the midwives, who very willingly submitted, were found
to be healthy, their preparations and appliances were found faultless,
and their establishments in thoroughly clean condition and
sanitary. Secondly, three cases were admitted where the diagnosis
was made after other diagnoses had been made outside. One of
those had been considered to be acute intestinal obstruction, while
the other two were being treated as cases of rheumatic fever. Had
those three cases died at home they certainly would not have
figured as maternal deaths.
One naturally asks, also, if the consultative service made
available had not something to do with the increase. From the
twenty consultations attended by the Obstetric Officer during the
year, seven cases were admitted to the Borough Hospital as
Puerperal Sepsis.
Only three of the admissions were from Municipal units. One
case of Puerperal Fever was admitted from St. Mary's Hospital
following version for placenta praevia, and two cases of Puerperal
Pyexia were admitted from Mayday Hospital, one a pyelo-cystitis,
the other an angina simulating diphtheria.
Medically it is interesting to record that the cases of true
puerperal fever followed the general type. Only two of the eight
fatal cases had rigors, and in six of them the pulse rate was 140
per minute or higher. In the ten cases which were discharged
well, four had rigors, and in one instance only was a pulse rate of
140 recorded.
Blood cultures of haemolitic streptococci were found in three of
the fatal cases. Two cases with haemolitic streptococci demonstrated
the blood stream recovered.